Kidney Disease Raises Death Risk in Pregnant Women

Shailendra Sharma, MD, of the University of Colorado School of Medicine in Aurora, and colleagues compared 646 pregnancies among women with chronic kidney disease (CKD) with 62,757 pregnancies among women without CKD. Compared with women who did not have kidney disease, those with kidney disease had a threefold increased risk of death, after adjusting for age, race, history of diabetes, chronic hypertension, liver disease, and connective tissue disorders. Additionally, the women with kidney disease had a twofold increased risk of preterm delivery and a 38% increased risk for cesarean delivery.

The women with kidney disease were more likely than those without kidney disease to have comorbid conditions, including a history of chronic hypertension and diabetes.

Madeleine V. Pahl, MD, a researcher who has studied pregnancy in CKD patients but was not involved in the latest investigation, said the new study “truly merits mention as it is the first to show in a large patient population that CKD is associated with an increased risk of death in pregnancy.”

Although the finding is new, it is not surprising, said Dr. Pahl, Professor of Medicine and Director of the Fellowship Training Program in the Division of Nephrology and Hypertension at University of California, Irvine, in Orange, Calif. “CKD is associated with increased death in almost every study where it has been looked at as factor of mortality.”

It would be interesting to know if there was any effect of CKD stage on mortality and pre-term delivery, she added.